Knee replacement patient Rick Litavis (center) enjoys a post-surgery family stroll.

With three torn ligaments and no cartilage left in his right knee, 49-year-old Rick Litavis of Hopkinton, MA, had two options – continue to live in pain and suffer through sleepless nights, or get a knee replacement.

Rick was ready for relief.

And thanks to surgical expertise, teamwork, and an innovative approach to improving knee replacement outcomes, Rick was not only pain-free within days after his January 2013 operation, but also walking and biking within weeks.

“I was completely floored,” says Rick. “The first night after my surgery I was standing, the next day I was using a walker without pain, and I was home the day after that.”

After playing football at Northeastern University, Rick continued to play competitive, high-impact sports throughout his 20s and 30s. But such a lifestyle also comes with risks, and Rick managed to severely injure his right knee several times over the years.

Those mounting knee injuries led to increasing pain, decreasing physical activity, and sleeplessness. The lack of sleep, in turn, sapped his motivation and energy.

When he was ready for help, Rick turned to orthopedic surgeon Thomas Thornhill, MD, the same physician who had replaced both of his father’s knees during a single operation several years before.

Dr. Thornhill introduced Rick to a new and improved knee replacement process, developed through extensive research by the Department of Orthopedic Surgery’s Care Improvement Team.

The process started with emphasizing patient education – helping Rick prepare mentally and physically for the procedure – and making sure that Rick realized that he also was an important part of the care team. By adhering to best practices on his end (e.g., proper nutrition and exercise), Rick could contribute significantly to improving his recovery.

Next, according to the new protocol, Rick was given long-acting pain medications immediately before surgery instead of short-acting pain medications immediately after surgery. Long-acting medications, which can work for up to 12 hours, produce fewer side effects than short-acting medications and provide steady, continuous pain relief after surgery. Short-acting medications, on the other hand, only provide intermittent relief. Thus, Rick was in minimal pain immediately after surgery – step one to a quicker recovery.

But recovery didn’t mean relaxation.

The former stan­dard of care was to have a patient’s knee moved for them by a continuous passive motion machine shortly following surgery. Research by the Care Improvement Team, however, has demonstrated that this tech­nique actually increases the amount of pain and slows recovery. The orthopedic surgery team now uses a rehabilitation protocol that literally gets patients back on their feet within hours after surgery.

Rick stood up on the first night after his surgery. A few days after that, he was participating in active physical therapy – flexing his knee, picking his leg up off the floor and onto his bed, and walking.

Now, only months later, Rick, who turned 50 in March, enjoys frequent walks around a local lake with his son and wife and is looking forward to visiting, and trying to keep up with, his daughter who’s at school in New York City. He also has been golfing again and hopes to be able to walk 18 holes by the end of the year.

Based on his experience, Rick wonders why a qualified candidate for knee replacement surgery would wait.

“Why torture yourself for 10 more years?” explains Rick. “Why put yourself through pain and aggravation when you can live happily and do the things that you want to do?”

– Chris P.


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